1. Determine the subtrahend extraction should be the measurement of the tooth model analysis, especially through the row of teeth test aligned teeth required clearance and calculating the upper and lower teeth Bolton index.
2. General situation for the upper and lower front teeth using X-ray examination, Periodontal root has Cogging absorption, short root malformations, conditions should be according to full mouth panoramic X-ray films to show whether other parts of the impacted teeth , hypotonic malformations.
3. Crowding to determine the subtrahend extraction tooth position, often consider the removal of the first premolars, because of its location near the front teeth, and dental equipment the whole arch has four pairs of the first premolars after removal of the less affected, but if the arch there are more severe caries or hypoplasia of the teeth, tooth the subtrahend extraction then the correction level should be preferred to removal of carious teeth.
4. When the calculated aligned crowded the number of teeth required for clearance, then the treatment process may be loss anchorage may cause anchorage tooth forward the number added to Brushing their teeth a good mouthwash the amount of the required clearance, in general, fixed orthodontic appliances on each side to lose support removable loss of orthodontic anchorage in the amount of more anti-2mm.
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